Healthcare Provider Details

I. General information

NPI: 1497568315
Provider Name (Legal Business Name): ASHLEY ANNE GRIMES ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY ANNE ERNST

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4513 EXECUTIVE DR
NAPLES FL
34119-9033
US

IV. Provider business mailing address

5610 SHADY OAKS LN
NAPLES FL
34119-1254
US

V. Phone/Fax

Practice location:
  • Phone: 239-591-2803
  • Fax:
Mailing address:
  • Phone: 239-273-4310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11037348
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: